Understanding Medicare Supplemental Insurance Plans

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As seniors near retirement, their healthcare needs may become more complex. Original Medicare, comprised of Parts A and B, may not provide coverage for all of their medical expenses. Fortunately, Medicare Supplemental Insurance plans, also known as Medigap plans, can help bridge this gap in coverage. Here’s what you need to know.

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What are Medicare Supplemental Insurance Plans?

Medicare Supplemental Insurance plans are designed to help cover the gaps in coverage that Original Medicare doesn’t cover. These plans are sold by private insurance companies and are standardized across the United States, with each plan type offering the same benefits from state to state.

There are ten different types of Medicare Supplemental Insurance plans, each labeled with a letter from A to N. While the benefits of each plan letter are standardized, the costs may vary depending on the insurer and the state in which you live.

What Medicare Supplemental Insurance Plans Cover

Each plan letter offers a different set of benefits, with Plan A offering the fewest benefits and Plan F offering the most comprehensive coverage. Here’s a breakdown of what each plan letter covers:

Medicare Supplemental Plan Letter
Covered Benefits
Plan A
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up, Medicare Part B coinsurance or copayment, first three pints of blood, and hospice care coinsurance or copayment.
Plan B
Everything covered by Plan A, plus the Medicare Part A deductible.
Plan C
Everything covered by Plan B, plus skilled nursing facility care coinsurance, Medicare Part B deductible, and emergency foreign travel coverage.
Plan D
Everything covered by Plan B, plus skilled nursing facility care coinsurance and Medicare Part B deductible.
Plan F
Everything covered by Plan C, plus Medicare Part B excess charges, and 100% of Part B preventive care coinsurance.
Plan G
Everything covered by Plan F, except the Part B deductible.
Plan K
50% of Medicare Part A coinsurance and hospital costs, first three pints of blood, Medicare Part B coinsurance or copayment, hospice care coinsurance or copayment, and 50% of skilled nursing facility care coinsurance.
Plan L
Everything covered by Plan K, plus 75% of the Medicare Part A deductible and 75% of the Part B deductible.
Plan M
Everything covered by Plan D, except the Medicare Part B deductible.
Plan N
Everything covered by Plan D, except for Medicare Part B deductible and Part B excess charges.

It’s important to note that as of January 1, 2020, Plan F and Plan C are no longer available to new Medicare beneficiaries. However, if you were eligible for Medicare prior to that date, you may still be able to enroll in one of these plans.

How to Enroll in a Medicare Supplemental Insurance Plan

While Medicare Supplemental Insurance plans are sold by private insurance companies, they are regulated by the federal government. To enroll, you must first be enrolled in Medicare Part A and Part B. You can then purchase a Medigap plan from any insurance company that is licensed in your state.

The best time to enroll in a Medicare Supplemental Insurance plan is during your Medigap Open Enrollment Period, which begins the month that you turn 65 and are enrolled in Medicare Part B. During this time, insurance companies must sell you a policy regardless of your medical history or pre-existing conditions, and they cannot charge you more for coverage based on your health.

If you miss your Medigap Open Enrollment Period and want to enroll in a plan later, you may be subject to medical underwriting, which means that insurance companies can charge you more based on your health status or deny you coverage altogether.

The Cost of Medicare Supplemental Insurance Plans

The cost of a Medicare Supplemental Insurance plan varies depending on the insurer, the state in which you live, and the plan letter that you choose. Premiums can also increase over time, so it’s important to carefully consider the long-term costs of a plan before enrolling.

When comparing plans, it’s important to consider not only the monthly premium, but also any deductibles, copayments, and coinsurance that may apply. Some plans may have lower monthly premiums but higher out-of-pocket costs, while others may have higher monthly premiums but lower out-of-pocket costs.

Frequently Asked Questions

Do I need a Medicare Supplemental Insurance plan if I have Medicare Advantage?

No, if you have a Medicare Advantage plan, you do not need a Medicare Supplemental Insurance plan. Medicare Advantage plans are a type of Medicare health plan offered by private insurance companies that provide all of your Medicare Part A and Part B coverage, often with additional benefits such as vision, hearing, and dental coverage.

Can I change my Medicare Supplemental Insurance plan?

Yes, you can change your Medicare Supplemental Insurance plan at any time. However, if you are outside of your Medigap Open Enrollment Period or have a pre-existing condition, you may be subject to underwriting and may not be able to switch to a different plan.

What if I can’t afford a Medicare Supplemental Insurance plan?

If you can’t afford a Medicare Supplemental Insurance plan, you may qualify for financial assistance through your state’s Medicaid program. Some states also offer programs that can help you pay for your Medicare premiums and other healthcare costs.

Are there any Medicare Supplemental Insurance plans that cover prescription drugs?

No, Medicare Supplemental Insurance plans do not cover prescription drugs. If you need coverage for prescription drugs, you will need to enroll in a Medicare Part D plan or a Medicare Advantage plan that includes prescription drug coverage.

What happens if I move to a different state?

If you move to a different state, you can keep your Medicare Supplemental Insurance plan as long as the plan is offered in your new state. If your plan is not available in your new state, you may need to enroll in a new plan. You may also be able to switch to a different plan during the Medigap Open Enrollment Period.

Conclusion

Medicare Supplemental Insurance plans can provide valuable coverage for seniors who need help covering the gaps in their Original Medicare coverage. By understanding the coverage options and costs of each plan, you can make an informed decision about which plan is right for you.

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